Title: Reimbursement Analyst
Department Org: Patient Financial Svcs - 108870
Employee Classification: J1 - Salaried Full Time HSC
Bargaining Unit: Bargaining Unit Exempt
Primary Location: Health Science Campus Hospital
Shift: 1
Start Time: 8:00am End Time: 4:30pm
Posted Salary: $38,672 -$53,220
Float: False
Rotate: False
On Call: False
Travel: False
Weekend/Holiday: False
Job Description:
Acts as departmental subject matter expert to p2yer reimbursement issues and Monitors payer reimbursement and denial patterns to identify underpayment opportunities to increase cash collections. Works with the charge master and managed care teams to monitor reimbursement according to contracts, assist personnel who facilitate refunds as needed; and works with others in department as requested by management to review Patient Financial Services issues. Prepares accurate written reports and analyses including financial reports, contract management performance metrics, adverse trends and appropriate recommendations or conclusions. Communicates and interacts with multiple UTMC personnel, Networks and Third Party Administrators (TPAs) in resolving variances.
Assists with implementation of system upgrades.
Minimum Qualifications:
Education/experience/licensing:
• Bachelor degree in Account, Finance, Healthcare or Business Administration preferred; or 5-10 years of Managed Care Contract Reimbursement experience in lieu of degree may be considered. High school diploma or GED required.
• Knowledge of ICD-9 and ICD-10 coding, billing and collections and Managed Care contract language required.
• Proficiency in Microsoft Office, required.
Required Communication and other skills:
• Excellent human relations and oral/written communication skills required.
Preferred Qualifications:
• Bachelor degree in Account, Finance, Healthcare or Business Administration preferred
• Knowledge of revenue cycle procedures preferred.
• Experience with a variety of hospital patient accounting, billing, and contract management systems preferred.
• McKessen STAR knowledge preferred.
Conditions of Employment:
All UToledo employees on all campuses, including those working on campus and working remotely, are required to be fully vaccinated against Covid-19, or have an approved exemption.
To promote the highest levels of health and well-being, the University of Toledo campuses are tobacco-free. To further this effort, the University of Toledo Health Science Campus Medical Center is requiring candidates for employment to be nicotine-free. Pre-employment health screening requirements will include cotinine (nicotine) testing, as well as drug and other required health screenings for the position. With the exception of positions within University of Toledo Main Campus and the University of Toledo College of Medicine and Life Sciences, the employment offer is conditional upon successful completion of a cotinine test and Occupational Health clearance.
Equal Employment Opportunity Statement:
The University of Toledo is an equal opportunity, affirmative action employer. The University of Toledo does not discriminate in employment, educational programs, or activities on the basis of race, color, religion, sex, age, ancestry, national origin, sexual orientation, gender identity and expression, military or veteran status, disability, familial status, or political affiliation.
The University is dedicated to the goal of building a culturally diverse and pluralistic faculty and staff committed to teaching and working in a multicultural environment and strongly encourages applications from women, minorities, individuals with disabilities, dual-career professionals and covered veterans.
The University of Toledo provides reasonable accommodation to individuals with disabilities. If you require accommodation to complete this application, or for testing or interviewing, please contact the Human Resources Department at 419-530-4747 between the hours of 8:30AM and 5:00PM or apply online for an accommodation request.
Computer access is available at most public libraries and at the Office of Human Resources located in the Center for Administrative Support on the Main Campus of the University of Toledo.
